Archive for February, 2010

The orgasm has been compared to a sneeze – they’re both involuntary muscle spasms.

I think I can draw a more useful parallel:  a laugh.

Laughing is certainly more fun than sneezing, and there’s another useful similarity – they’re both about relaxing, and letting yourself have fun.

Most of my patients who have trouble attaining an orgasm are able to climax when they’re alone, but not with another person – especially not with someone they know.

It’s hard to relax enough to have an orgasm in someone else’s presence.  It’s also hard to laugh with a stranger.  That’s why the number one thing my patients say they are looking for in a partner is “someone who can make me laugh.”  It’s a sign that you’ve achieved a connection – you can let go and relax and laugh.  You feel safe enough to be yourself.

Sex is a barometer for communication in a relationship.  If a couple stops having sex, their communication has usually shut down.  There’s something they aren’t talking about, and it shows.  They’ve tensed up and stopped talking – the trust in their relationship is compromised.  That breakdown of trust is reflected in their discomfort opening up sufficiently to do something as awkward and private as get naked and have sex.

For some of my patients, having sex with strangers is easier than sex with someone they know because they can hide with a stranger.  In some sense, they are alone, since there’s no real connection, so they can let go.

It’s interesting that a good comedian’s job is to relax us enough that we laugh in the presence of others.  The best comedians can make you laugh even if you’re trying not to – it really is involuntary.  They do this by surprising us with forbidden communication.  Ironically, one of the easiest way for a comedian to get a cheap laugh is by “working blue” – talking about sex in an open way that surprises the audience into admitting truths about themselves.

In order to relax enough to have an orgasm, you need to own the forbidden feelings around this act of supreme openness. Instead of beating yourself up for having a “problem,” you can treat your feelings with respect, own them, and explore them.

Why is it scary to open up and relax around another person?

Probably because when you did it before, in the past, you got hurt.

Simple enough.  A trained response, just like Pavlov’s dogs.

So you’re going to have to respect that trained response, and address it by reassuring yourself that this time you’re safe.

Maybe, as a child, it wasn’t safe to open up and be yourself, relaxed and present.  You learned to close down and assume a defensive posture.

But as an adult, there’s nothing you can’t handle – because you always have yourself nearby.

Someone’s got your back.

So go ahead.  Laugh.  Or sneeze.  Or whatever.

It’s going to be okay this time.

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The People’s Therapist now has fans.  Literally.

I’ve created a “fan page” on Facebook.

To become a “fan” please go to my Facebook “fan page” and click “become a fan.”


You will subsequently become eligible for all the rights and privileges that befit a loyal fan of The People’s Therapist.

Mostly, that means I can send you updates about the site and perhaps the publication of a book or an event I’ll be featured in – that sort of thing.

It will also make me feel good.


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Most of the Western world seems to have had a good laugh this week at an unidentified Arab ambassador to Dubai.

This gentleman rushed to annul his marriage contract and cancel his wedding after he finally got a look at his bride-to-be’s face and realized she was cross-eyed and had a beard.  She’d worn a niqab, a heavy veil, during their courtship, so he’d never actually laid eyes on her until moments before they tied the knot.

It’s a great story, and it does seem pretty silly to marry a woman when you haven’t even seen her face.

But before we laugh too hard at another culture’s ridiculous, sentimental notions, maybe we should take a look at some of our own.

Like marriage.

The People’s Therapist is well aware that he sounds like a grinch when he writes about this subject, but here goes.

Marriage makes no sense.  It is a lot of sentimental clap-trap.

And I’m sorry, gay folks, but you’re out of your minds if you think this tired old convention is going to make you any happier than it’s made the heteros.

A couple is happy because it’s happy.  Getting married, if it has any effect at all, usually only helps to break you up.

Before you start drafting that angry comment, consider the reality of a wedding.  You stand with your partner, your best friend, someone with whom you share a very personal, private relationship – in front of a roomful of family, friends and near-strangers. What do you do in front of all those people?  Promise you will stay together forever.

No one can promise that.

A relationship takes place in the moment.  You probably have a shared dream – someplace you want to go together, and that’s great.  But no one knows if that dream will last, or if you’ll get there.  That’s why it’s a dream.

Relationships are like movie film – lots of tiny boxes with a little piece of shared experience captured in each one.  When you take all those little moments of shared experience and line them up, it tells a story that seems inevitable.  But it never was inevitable, and there’s no way to know what’s coming next.

The worst part is that couples often become hyper-focused on the wedding itself.  These affairs can be enormous undertakings nowadays, which grow into monsters that gobble your life.  The wedding -essentially a big party for your relatives – can become the shared dream.

That means, when the wedding’s over…there’s nothing left to chase.  Some couples find themselves staring at one another, blinking in the sunlight, wondering what to do next.  And that thing to do next might not be something they want to do together.

Maybe the ultimate reason I’m so down on marriage is that I’m a therapist, and I’ve seen divorce, up close and personal. And yes – gay divorce, too.

It’s awful.

I don’t know if it’s the rotten state of divorce laws – they date back to the Victorian era, when a woman was essentially a piece of property – or just the broken dream itself, but people can lose their minds during divorces.  I’ve seen couples sue one another until they’re both bankrupt, and then keep suing.  The lawyers are happy to take their money until there’s none left, at which point they walk away and leave the unhappy partners to battle it out on their own.

It’s ugly.

But most marriages end that way.  In divorce.  In the US, 50% percent of first marriages, 67% of second and 74% of third marriages end in divorce.


I’m sorry. I might be the Grinch. But I didn’t invent that reality.  It just is.

Instead of bemoaning the death of family – or whatever you want to call it – how about we face the fact that you can’t judge the quality of a relationship based upon its longevity.  You might spend a marvelous three years with someone and decide that it’s time to move on. Or you might stay together for sixty years and be totally miserable.

It’s not about staying together with the same person forever.  It’s about finding something that works in the moment – the here and now – and enjoying it.  Wake up each and every day as though it were the first day all over again, and decide then and there if it’s  where you still want to be.  If it is – great.  It is isn’t – also great.

Why does that seem so awful?

Because there’s a child inside you who longs for stability.  All children crave stability – it’s what they thrive upon.  And marriage regresses us into that child.

An adult doesn’t need a relationship or a ceremony to provide him stability.  He carries it within himself.  He can leave one relationship, be by himself, or enter another relationship.  It doesn’t matter that much.  He’ll do just fine.

An adult doesn’t need a parent – he contains his own parent.  His partner can be his friend, his ally, his playmate, his companion – his equal.

An adult is a whole person, not a half person.  And if the other whole person leaves to try something different, he remains a whole person.

I suspect there ought to be some sort of legal protection for couples who have children.  Perhaps civil union is the answer for those legal issues.

But traditional marriage is a silly, out-dated custom.

When you pull up the veil, and see what’s really there, you might be in for an unpleasant surprise.

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The other day, I was listening to a patient explain to me why he was ugly and no one could possibly find him attractive.

This was news to me, because so far as I could tell he was a very handsome guy – film star handsome.  It was a puzzling case.

Let’s talk about beauty – plain old physical appearance.

The first steadfast rule is summed up by the old cliche – beauty is in the eye of the beholder.

If you’ve never thought about what that really means, let’s do it here.

The fact is there is no standard for beauty.  That’s a myth.  The gossip mags and entertainment shows on television hold up one star after another as the ideal, but it’s not true.  Only you decide to whom you are attracted, and your taste doesn’t have to match anyone else’s.

Different eras have held widely varying ideas about what is beautiful.  Even now, Americans are only beginning to open their eyes to the beauty of different ethnicities whose images were almost entirely absent from the popular media for centuries.

Just as you have a right to decide whom you think is beautiful – other people have that right, too. And it is quite possible someone might decide his ideal of beauty is…you.

My patient had been told by various people that he was handsome, and some had even attempted to pursue him, but he’d always dismissed their interest.  He couldn’t accept that other people didn’t see what he saw when he looked in the mirror:  he was too short, had bad skin, bad teeth, a bump on his nose.  Even as he enumerated these terrible flaws, I strained to see what he was talking about.  I looked – and saw a handsome guy.

The problem wasn’t with how this guy looked.  It was with the messages he was given as a child.

His parents had him when they were very young, and their marriage soon broke up.  The father, caught up in a nasty divorce battle, fought for custody of my patient and won it, only to dump the boy on resentful relatives.  My patient grew up receiving the message that his presence was a nuisance – that people wished he wasn’t there.  He learned that he was nothing special – certainly no one whom anyone would notice or be attracted to.

My patient went on to succeed in his career, against the odds.  Despite his parents’ disinterest, he worked hard in school and rose to an impressive position in the business world.  But he still felt ugly – nothing special.  His physical appearance became a container for all the feelings his parents put in him about himself.

In our session, I reminded him that his parents were old now, and far away – he hardly saw them anymore.  Nowadays he was the one in charge of parenting the little boy inside him.  And he was doing a lousy job of it.

I asked him when he first became ugly.

He shrugged.

I asked him whether he was ugly back when he was a little boy.   Was he ugly at 6?  At 10?  At 12?  When did the ugliness first arrive?

He shrugged, and said he’d always felt that way.

I asked him if there was such a thing as an ugly little boy.

He said, no, probably not.

So were you ugly when you were 7?

He said he didn’t know – probably.

I said of course not.  There is no such thing as an ugly 7 year old.  In fact there is no such thing as an ugly child.  No child is ugly because every child is unique and beautiful.

So why are you treating this child with such cruelty – telling him such terrible things about who he is?

The messages my patient was addressing to his child were the same ones his parents sent him.  A psychotherapist calls these messages “negative introjects” – voices that were put inside you as a child, messages that keep playing years later, like:

You are a nuisance.  You are nothing special.  You are always in the way.  We wish you weren’t here.

I asked him to create some healthier messages for his child self.

He looked at me blankly.   Like what?

Well, let’s pretend your mother wasn’t absent from your life when you were little.  Let’s pretend she took you up in her lap when you were a boy and said something like:

You are my little one, my precious little fellow.  You are handsome and good and you make me proud.  You are my boy, my special boy.  You are beautiful.  You are my treasure.

Tears started to run down my patient’s face.

She never said anything like that.

I know.  But you can say it.  You don’t have to feel ugly.  There’s nothing ugly in you and nothing ugly about you.  You deserve love because you are beautiful.  Inside and out.

Please don’t tell your child he is ugly.  He isn’t.  He’s you, and he deserves your love, so he can learn to accept love from the world outside.  It’s critical to his happiness.  Please be a better parent to that little child.

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The People’s Therapist displayed his legendary tact and discretion during a recent interview with the lovely and talented Kashmir Hill, Associate Editor of the esteemed yet tasty legal blog,

Despite my best efforts, tongues appear to be wagging regarding certain shocking revelations about The People’s Therapist’s previous incarnation as a high-powered Wall Street lawyer at Sullivan & Cromwell, a top white-shoe firm.  To put it bluntly – though I am loathe to – I told the truth about the toxic environments at big law firms, and the psychological toll they take on the people who work there.

Twitter is a-buzz and Buzz is a-twitter with these shocking revelations.  Facebook is…uh…blue in the face.


Here’s the link for the interview.

For more juicy brilliance from the lovely and talented Kashmir Hill, you can also check this out this site (highly recommended by The People’s Therapist.)

Those of you with heart conditions or delicate sensibilities – please exercise caution.

This material may be inappropriate for young children or those recently graduated from law school.

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Children need a lot of attention.  When they don’t get it, they’ll often act out – misbehave – in a desperate attempt to be paid attention to, even if the result is negative attention.

I had a patient who used to vomit frequently as a child.  It became an unpleasant regular event during family meals – but he managed to distract his mother for a few minutes.  Even if she was cross and impatient with him, at least she was paying attention.

Scott Brown, the newly-elected US Senator from Massachusetts, grew up in a family where there wasn’t much time available to devote to raising children.  His parents divorced when he was an infant, and both the mother and the father have since remarried three times each.

Scott’s mother was living on welfare at various periods during his youth, and Scott sometimes ended up getting shipped off to live with his grandparents or his aunt.  He had siblings, too.  My guess is there were enough other children around to consume whatever time was available for Scott.

How did the young Scott Brown respond to this situation?  He acted out – badly.  By the time he was 12 years old, Scott was arrested for shop-lifting from a record store and brought before a judge.

This is where things get interesting.  Brown’s story is that the judge, Samuel Zoll, shamed him by sentencing him to write a 1500-word essay on how his siblings would feel watching Brown play basketball in jail.

The People’s Therapist suspects something else happened, too.  Scott had finally forced a father figure – Judge Zoll – to pay attention to him.

That’s why he stole from the record store in the first place.  He didn’t need records.  He needed a parent-figure’s attention.  And he got it – even if it was negative attention.

From that point on, we see a string of events suggesting that grabbing attention – even negative attention – became an unconscious impulse in Brown’s life.  Here are a few examples that jump out at you:

1.  Posing nude for Cosmopolitan Magazine as a law student;

2.  Using the “F-word” as a State Senator during a debate on gay marriage at a high school; and

3.  Presenting his daughters, Ayla and Arianna Brown, as “available” (whatever that was supposed to mean) during his acceptance speech for the US Senate.

The biggest attention-getter of all was politics itself.  Brown seemed to run compulsively for everything there was to run for, from Property Assessor to Selectman to State Representative to State Senator.

This latest campaign, for the US Senate, was an even bigger attention-getter, and once again, it was negative attention. Brown’s role was the spoiler.

Teddy Kennedy, a legend in the Senate, devoted much of his life to fighting to guarantee decent healthcare for all Americans. On the cusp of achieving this goal, Kennedy died after a courageous battle with brain cancer.  Brown’s job?  To get elected on a wave of Tea-Party cash, so he could shatter Kennedy’s dream.  Brown had to get elected so he could be the 41st vote that would allow the small Republican minority from mostly under-populated states, representing an even tinier minority of Americans, to abuse the filibuster rule and destroy years of hard work by blocking healthcare reform.

We can only hope a father figure – perhaps President Obama could fill in for Judge Zoll? – will arrive to give Brown the attention he needs.  Maybe he should be forced to write a 1500-word essay on how his siblings would feel watching him destroy a chance at decent, affordable healthcare for millions of Americans.

This country has had enough of angry little children in positions of authority.

We need leaders who can behave like adults – who win our admiration for what they achieve.  We do not need another attention-grabbing miscreant who will stop everyone in their tracks by throwing up at dinner.

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Here’s further evidence that Sigmund Freud didn’t invent the concept of psychotherapy out of thin air:

There was a precursor, and his name was Charles Dickens.

Way back in 1843, thirteen years before Freud was born, Dickens wrote a book summing up the process of psychotherapy.

The title of this scholarly tome?  You’ve probably read it – or perhaps you are familiar with one of the film versions.  My personal favorite stars the legendary Scrooge McDuck.

I’m only half-kidding.  So let’s review the storyline of A Christmas Carol, and see how it relates to the process of psychotherapy.

The plot should be familiar to most of us:

It’s Christmas Eve, and the old miser, Ebenezer Scrooge, is at his office, being unpleasant to everyone around him.  Scrooge scoffs at his nephew’s invitation to a Christmas party, refuses to donate to charity and scolds his employees, letting everyone know his top priority is money, not relationships with other people.

The diagnosis is pretty clear.  Scrooge is unconsciously clinging to money as a surrogate for love.  He doesn’t feel cared for by anyone, and perhaps he believes he is undeserving or incapable of attracting the love he needs.  Scrooge discharges anger indiscriminately at whomever is nearby, chasing away anyone who attempts to offer him care.

Eventually Scrooge leaves his office and heads home, where he is confronted by the ghost of Marley, his old business partner, who has organized an intervention. Marley informs Scrooge in no uncertain terms that he has to do some work on himself or he’ll end up just like Marley did – dragging metaphorical chains around, miserable and unloved.  Marley recommends psychotherapy.

Plenty of my patients come to me on the advice of friends.  There’s something about hearing from a good old comrade for the one hundredth time that you “really should think about seeing a therapist” that eventually brings someone around.  That’s especially true when – like Scrooge – it’s clear that you’re miserable.  It also helps when the friend, like Marley, admits he’s had some of the same issues himself.

Marley goes so far as to recommend his own therapists – and to make the appointments.  He lets Scrooge know that three ghosts will be dropping by that night for some serious counseling work, and that it will be very experientially-oriented, probably with a Gestalt focus and incorporating some aspects of psychodrama.  Marley has even paid the fee in advance.  There’s friendship for you.

Scrooge is skeptical – after all, he’s never done psychotherapy before, so he figures he’ll play along, but doesn’t expect much.

The first ghost arrives – the ghost of Christmas past.  He’s an old school psychoanalyst and wants to start right off with deep psychodynamic exploration – digging deep into Scrooge’s past, examining the environment in which little Ebenezer grew up and how it shaped his patterns of behavior and the assumptions he makes about the world around him.

Scrooge learns that his fear of risking authentic contact – opening himself up in a way that would permit meaningful contact with others – resulted in his fleeing to money as a replacement for the love he needed.  Instead of being generous and open-hearted like old Fezziwig, his first employer, and containing his anxiety, Scrooge acts out on his unexamined feeling and flees from Belle, the girl he loves.  Scrooge ends up surrounding himself with money – a compensation for feeling that he is unloved and unlovable.

The next therapist (er, ghost) to visit is representing Christmas present.  This guy is probably from the Albert Ellis Institute – his orientation is clearly cognitive-behavioral.  He has no time to waste digging into the past and finding precursors for Scrooge’s behavior.  This therapist wants to work horizontally, not vertically – in the here and now, examining Scrooge’s thinking as it affects his daily behavior.  He takes Scrooge to see the folks who populate his life – Tiny Tim and Bob Cratchit at their humble home, and Scrooge’s nephew at a Christmas party.

Scrooge realizes he’s been self-isolating.  This is depression – Scrooge has been acting in on unexamined anger he’s long harbored at not receiving the care he needs.  His cognition – “money is the only thing I can trust” – needs to be reality-tested, and counter-thoughts formulated, such as “maybe people are important, too” and “perhaps if I stop being such a grump people might give me a chance.”

The third and final therapist arrives looking like he means business.  This guy is hard-core, probably one of those French existential types who reads a lot of Lacan and takes no prisoners.  This guy isn’t messing around.  He puts death front and center – the eternal inevitability at the conclusion of every life ever lived.  Scrooge sees what death really means – that his life is nothing more than a brief opportunity for joy – and that human connection is crucial to attaining that goal.  He realizes that this isn’t a dress rehearsal – it’s his one chance at existence, and he doesn’t get another run-through.

That does it.  The session with the French guy cracks Scrooge’s resistance, and new awareness arrives fast and hard.  He wakes up a new man.  With consciousness comes the desire for change.  Now that Scrooge can see himself – the roots of his patterns of behavior, the distortions in his current cognition, and the pressing insistence of his mortality – he longs to express his authentic self, his best self – to become the man he truly is.

Voila!  Another happy customer.  Psychotherapy changes another life for the better…thirteen years before the birth of Freud.

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